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The state of dentistry in Serbia: Challenges and realities

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The dental market in Serbia currently ranks among the lowest in Europe based on official business metrics. Analysts highlight a notable gap between reported and actual income within the profession. According to data from the “Batut” Institute, only 11% of Serbian citizens retain all their teeth.

Despite the common belief that private dentists in Serbia earn as much as their counterparts in neighboring countries, many practitioners report struggling financially. They suggest that a luxurious lifestyle is reserved for a small number of practice owners who have established a solid client base.

Concerns about the transparency of dentists’ earnings stem from their taxation structure. Unlike many other professions, dentists pay a flat tax rather than one based on revenue. They often fail to issue fiscal invoices for most services, despite legal requirements, with many patients paying cash—often in euros, which is technically illegal.

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As reported by Makroekonomija.org, this situation pushes dental services more into the gray or black market. In 2021, Serbia had 1,417 registered private dental practices, yet dentists estimate the actual number is double that, employing around 3,846 people. Countries like Estonia, Slovenia, Malta, Bosnia and Herzegovina, Cyprus and Luxembourg have fewer dental employees than Serbia.

The added value generated per employee in the dental sector is just €7,700, placing Serbia last in Europe. This figure represents only 41% of the national average added value per employee, which stands at €18,800. With a reported added value of €19.2 million from dental services, only Malta—home to 13 times fewer inhabitants—reported a lower figure of €18.3 million.

Labor costs in Serbia account for a staggering 63.9% of added value in dental services. As noted by Makroekonomija, even “poor and beleaguered dentists” are not subject to capitalist exploitation.

In Serbia, the added value from dental activities amounts to just €2.80 per inhabitant, compared to €111.80 in the EU. The only country with a lower figure is Greece, at €10.50 per inhabitant, which is almost four times higher than Serbia.

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Oral health crisis

The dental health statistics in Serbia are concerning. Data from the Institute for Public Health shows that only 11% of the population has all their teeth, while approximately 700,000 individuals—16.6%—are completely toothless. Over 20% of men and 10% of women require dentures but have yet to pursue them.

The 2006 Health Insurance Law, which removed free dental services from mandatory health coverage, has exacerbated this situation. Currently, only children, students, pregnant women and certain vulnerable groups can access free dental care, and only if they can find a state office nearby. Everyone else must pay out-of-pocket for dental treatments.

The rationale behind these changes was to promote personal responsibility for health and encourage more regular dental visits. Unfortunately, the opposite has occurred. Former Health Minister Danica Grujičić has proposed restoring many free dental services for all citizens and integrating private practices into the state-funded system, similar to what is done with private pharmacies.

The Association of Private Dentists of Serbia has expressed a willingness to have at least five basic services, such as tooth extraction and cleaning, covered by health insurance. They believe private practices could begin offering these services for free to citizens “as soon as an agreement is reached” with the Fund.

The Dental Chamber of Serbia has refrained from commenting on these possibilities or on the state of the dental industry in general. Dentists who are willing to discuss these issues acknowledge that many earn average incomes and aspire to own their practices for greater earnings. They emphasize that patient volume—and consequently income—largely depends on the quality of services, pricing, location and effective marketing.

Rising costs amidst stagnant wages

Dentist Aleksandar Papić, who has worked in three dental practices in Belgrade, believes that earnings in the field are not competitive compared to other professions. “While some practice owners may have substantial incomes based on patient numbers and experience, many dentists without their own offices earn between €600 and €800 per month. Those on a commission basis can make between €1,000 and €1,500,” he explains.

Papić notes that dentist salaries have seen little change in recent years. While dental service prices have increased about 10% due to rising material costs, this does not reflect any growth in salaries. Despite significantly lower prices—sometimes up to ten times less than in other European countries—Serbia has not attracted many foreign patients seeking dental care.

“Most foreign patients come through recommendations or are guest workers,” Papić adds. Only a handful of dental practices actively seek to attract clients from abroad, and many foreigners remain skeptical about receiving treatment outside their home countries.

Job market challenges

The notion that dentists easily find employment is misleading. Although it may appear that dental offices are plentiful, many graduates struggle to secure jobs. “Many of my colleagues have faced difficulty finding work after finishing their studies, prompting them to either move abroad or take positions in pharmaceutical companies,” Papić remarks. With six dental schools in Serbia producing a significant number of graduates, finding a job can be challenging, especially for those without family connections to existing practices.

Papić highlights that the general population cannot take pride in their dental health or regular visits to the dentist. “The poor standard of living for most people, combined with the closure of state health centers that previously offered accessible dental services, has contributed to this issue. Many citizens do not prioritize preventive check-ups, often only seeking dental care when serious issues arise, leading to more costly treatments,” he explains.

Milivoje Stojanović, owner of a private practice in Belgrade, concurs, noting that the costs of dental materials have risen by 20% to 30% in recent years, while service prices have only increased by about 5%. He has resisted significant price hikes to avoid losing patients, many of whom are already struggling to maintain their dental health.

Stojanović believes there are too many dentists in Serbia compared to the past. “The number of private practices has grown, with many services becoming unaffordable for a large segment of the population. Restoring services in health centers would help ensure that more low-income citizens can access necessary dental care. I believe that health should be a priority for every country,” he concludes, having recently retired and passed his practice to his son, who now operates it independently.

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